Precancerous cervical disease generally produces no symptoms. When abnormal cells develop into cervical cancer, the following symptoms may appear:

• abnormal bleeding, occurring between menstrual periods or after sexual intercourse, douching or a pelvic exam

• increased vaginal discharge

• pain (most common in the late stages of the disease) Consult your doctor if you have any of these symptoms.

Preventive strategies to live by

Preventive strategies to live by

Here are the best ways a woman can cut her risk of cervical cancer:

Get Pap smears regularly.

Don’t have sex before age 18.

Quit smoking.

Be monogamous with a mate who is also monogamous.

Protect yourself from sexually transmitted diseases. Human papillomavirus, in particular, can lead to cancer of the cervix.

Discuss the HPV vaccine with your doctor.

Cervical cancer is a largely preventable disease, and one key to preventing it is to get a Pap smear regularly. The Pap test can detect precancerous disease, which can be treated successfully before it turns into cancer.

Women can also prevent cervical cancer in a more basic way. Many of the risk factors for the disease—early or multiple pregnancies, first intercourse at an early age and previous infection with human papillomavirus (HPV), herpes, gonorrhea or syphilis—are directly related to sexual activity. In fact, cervical cancer in many instances can be considered a sexually transmitted disease (STD). Many cases of cervical cancer can be prevented in the same way as other STDs.

The newest weapon in the battle against cervical cancer is the Gardasil vaccine, which protects against the types of HPV most likely to cause cancer. The American Cancer Society currently recommends this vaccine only for females ages 11 to 12, with catch-up vaccination for those ages 13 to 18. But adult women should discuss with their healthcare provider whether this vaccine might be right for them.

How the cancer takes hold

The cervix is the narrow neck of the uterus that opens into the vagina. Infection or other problems can cause cells on the surface of the cervix to become abnormal. In time, the abnormal cells can turn cancerous and spread deep into the uterus and to other organs.

HPV infection, also known as genital warts, is an especially common cause of cervical abnormalities that, left untreated, lead to cancer. It’s important to diagnose HPV early so it can be treated before cancer develops. However, early detection is challenging because many HPV warts are invisible to the naked eye. When they are visible, the warts may be small or large, raised or flat. If left untreated, they may grow in size and number, sometimes taking on a cauliflower-like appearance.

Early detection is also hampered by the fact that HPV usually doesn’t cause symptoms. Fortunately, the virus may show up in the results of a Pap smear.

The chances of getting HPV in the first place can be greatly reduced by eliminating high-risk behaviors. These include having sexual intercourse before age 18, and having multiple sex partners or a partner who isn’t monogamous. Essentially, any step that reduces a woman’s risk of contracting an STD also reduces her risk of eventually contracting cervical cancer.

The smoking connection

Smoking puts women at higher risk for HPV and consequently for cervical cancer. Smokers in one study were four times as likely as nonsmokers to develop genital warts. But it’s not clear whether the increased risk was due to cervical cell changes caused by smoking itself or to differences in lifestyle between smokers and nonsmokers.

If your mother was given the drug diethylstilbestrol (DES) during pregnancy to prevent miscarriage, you’re at increased risk for cervical cancer. Any condition that weakens the immune system, such as hepatitis, also will make you more prone to cervical cancer. You should discuss all your risk factors openly with your doctor so that he or she can develop a schedule of checkups for you and appropriate follow-up, if necessary.

Not all cases of cervical cancer are preventable, but many are. Women should remember to get a Pap smear regularly. And they should know the symptoms, listed below, that should be reported to a doctor.